Hypothiazid 25 mg tablets 20
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1 tablet contains:
Active substance: hydrochlorothiazide 25 mg;
Excipients: magnesium stearate; talc; gelatin; corn starch; lactose monohydrate.
Hypothiazide is a diuretic.
The primary mechanism of action of thiazide diuretics is to increase diuresis by blocking the reabsorption of sodium and chlorine ions at the beginning of the renal tubules. By doing so, they increase the excretion of sodium and chlorine and, consequently, water. The excretion of other electrolytes, namely potassium and magnesium, is also increasing.
In maximum therapeutic doses, the natriuretic/diuretic effect of all thiazides is approximately the same. Natriuresis and diuresis occur within 2 hours and reach their maximum after about 4 h. They also reduce the activity of carbonic anhydrase by increasing the excretion of the bicarbonate ion, but this action is usually weak and does not affect the pH of urine. Hydrochlorothiazide also has hypotensive properties. Thiazide diuretics do not affect normal blood pressure.
Hydrochlorothiazide is incomplete, but is quickly absorbed from the digestive tract. This effect persists for 6-12 h. After ingestion, a dose of 100 mg of CMax in the blood plasma is achieved after 1.5-2.5 hours.
At the maximum diuretic activity (approximately 4 hours after administration), the concentration of hydrochlorothiazide in the blood plasma is 2 μg / ml. Binding to blood plasma proteins is 40%. It is excreted mainly through the kidneys (filtration and secretion) in unchanged form. T1 / 2 for patients with normal renal function is 6.4 h, for patients with moderate renal function insufficiency - 11.5 hours, and for patients with Cl creatinine less than 30 ml / min - 20.7 hours.
Hydrochlorothiazide penetrates the placental barrier and is excreted into breast milk.
Indications for use
- arterial hypertension (used both in monotherapy and in combination with other antihypertensive drugs);
- edematous syndrome of various genesis (chronic heart failure, nephrotic syndrome, premenstrual syndrome, acute glomerulonephritis, chronic renal failure, portal hypertension, corticosteroid treatment);
- control of polyuria, mainly in nephrogenic diabetes insipidus;
- prevention of the formation of stones in the genitourinary tract in predisposed patients (reduction of hypercalciuria).
- hypersensitivity to the drug or other sulfonamides;
- severe renal (Cl creatinine - less than 30 ml / min) or liver failure;
- hard-to-control diabetes mellitus;
- Addison's disease:
- refractory hypokalemia, hyponatremia, hypercalcemia;
- children's age up to 3 years (solid dosage form).
Use with caution in hypokalemia, hyponatremia, hypercalcemia, in patients with coronary artery disease, with cirrhosis of the liver, gout, in the elderly, in patients suffering from lactose intolerance, when taking cardiac glycosides.
Dosage and Administration
Inside, after eating.
The dosage should be selected individually. With constant medical supervision, the minimum effective dose is established.
Due to the increased loss of potassium and magnesium ions during treatment (the level of potassium in the serum may decrease below 3.0 mmol / l), there is a need to replace potassium and magnesium.
Adults. As an antihypertensive agent, the usual initial daily dose is 25-50 mg once, as monotherapy or in combination with other antihypertensive agents. For some patients, an initial dose of 12.5 mg is enough, both in the form of monotherapy and in combination. It is necessary to apply the minimum effective dose, not exceeding 100 mg / day. If Hypothiazide® is combined with other antihypertensive drugs, it may be necessary to reduce the dose of another drug in order to prevent an excessive decrease in blood pressure.
The hypotensive effect manifests itself within 3-4 days, but it may take up to 3-4 weeks to achieve the optimal effect. After the end of treatment, the hypotensive effect persists for 1 week.
Edematous syndrome of various genesis. The usual initial dose in the treatment of edema is 25-100 mg of the drug 1 time per day or 1 time in 2 days. Depending on the clinical response, the dose can be reduced to 25-50 mg 1 time per day or 1 time in 2 days. In some severe cases, doses of up to 200 mg / day may be required at the beginning of treatment.
In premenstrual syndrome, the usual dose is 25 mg / day and is used in the period from the onset of symptoms to the onset of menstruation.
In nephrogenic diabetes insipidus, the usual daily dose of 50-150 mg (in several doses) is recommended.
Children. Doses should be set based on the body weight of the child. The usual pediatric daily doses - 1-2 mg / kg or 30-60 mg / m2 of body surface, are prescribed once a day. The total daily dose for children aged 3 to 12 years is 37.5–100 mg.
Hypokalemia, hypomagnesemia, hypercalcemia and hypochloremic alkalosis: dry mouth, thirst, irregular heart rhythm, changes in mood or psyche, cramps and muscle pain, nausea, vomiting, unusual fatigue or weakness. Hypochloremic alkalosis can cause hepatic encephalopathy or hepatic coma.
Hyponatremia: confusion, convulsions, lethargy, slowing down the thinking process, fatigue, excitability, muscle cramps.
Metabolic phenomena: hyperglycemia, glucosuria, hyperuricemia with the development of a gout attack. Treatment with thiazides can reduce glucose tolerance, and latent diabetes mellitus can manifest. When using high doses, serum lipid levels may increase.
From the gastrointestinal tract: cholecystitis or pancreatitis, cholestatic jaundice, diarrhea, sialadenitis, constipation, anorexia.
From the cardiovascular system: arrhythmias, orthostatic hypotension, vasculitis.
From the nervous system and sensory organs: dizziness, blurred vision (temporarily), headache, paresthesia.
From the organs of hematopoiesis: very rarely - leukopenia, agranulocytosis, thrombocytopenia, hemolytic anemia, aplastic anemia.
Hypersensitivity reactions: urticaria, purpura, necrotizing vasculitis, Stevens-Johnson syndrome, respiratory distress syndrome (including pneumonitis and noncardiogenic pulmonary edema), photosensitivity, anaphylactic reactions up to shock.
Other phenomena: decreased potency, impaired renal function, interstitial nephritis.
- Dosage form
- 25 mg
- Number of tablets
- INN Russian
- Russian title